Ukraine veteran support

5. Mental health issues could become a critical bottleneck

As Ukraine plans for the long-term reintegration of its veterans, the country faces a challenge of exceptional scale and complexity. Years of full‑scale war have created an unprecedented demand for support services, particularly around mental health. This is happening when Ukraine’s mental health infrastructure has already been heavily strained and partially degraded during the war (Goto et al., 2023[40]).

At the same time, the social environment in which returning veterans will reintegrate poses additional structural challenges. Stigma surrounding disability and especially mental health remains widespread, contributing to both underutilisation of services and longstanding underinvestment in community‑based mental health care.

Compounding these issues is the broader strain on Ukraine’s labour market and public service workforce. The war has accelerated demographic decline, further reducing the (potential) pool of available mental health professionals and making capacity expansion difficult at a moment when demand is rising sharply. Critically, veterans will not only require large‑scale mental health support; many of them will also be essential to expanding the service‑delivery workforce itself.

Taken together, these factors create a highly challenging environment in Ukraine for ensuring effective mental health support for veterans across the country within and beyond the healthcare system. International experience shows that targeted policies and practices, co‑ordinated service delivery models, and strategic investment in personnel can help countries respond effectively under severe constraints. The following sections examine Ukraine’s current policy responses and draw lessons from relevant experiences in OECD and partner countries.

5.1. Rapidly improving psychological support for veterans in Ukraine

5.1.1. Emerging policy responses in Ukraine

In recent years, Ukraine has undertaken significant reforms to strengthen psychological support for its growing veteran population. Recognising that many returning service members face complex psychological and social challenges – including posttraumatic stress disorder (PTSD), anxiety, sleep disturbances, memory problems, and emotional instability – the government has moved toward a more structured, accessible, and professionally regulated system of care (Ministry of Veterans Affairs of Ukraine, 2024[41]). Psychological issues often impede reintegration into civilian life, reduce employability, and strain family relationships. Against this backdrop, psychological support has been elevated as an important component of national veteran policy, covering interventions ranging from basic counselling to intensive trauma‑oriented therapy.

5.1.2. A three‑tiered psychological support system

The Ministry of Veterans Affairs has adopted a three‑level framework to organise and scale access to psychological services (Department of Social and Veterans Policy, 2024[42]).

First level: Social and psychological support

The first tier serves as the primary entry point into the system. Veterans and their families can receive social and psychological assistance through local social protection departments, administrative service centres or district councils. The focus is on basic counselling, emotional support, crisis intervention, and guidance toward specialised services when needed. Services are intended to be easily accessible and geographically widespread, supporting early identification of emerging mental health needs.

Second level: Targeted psychological assistance

The second tier offers professional psychological care delivered by licensed providers. Veterans may access this level either by obtaining a referral from a primary care physician or by applying directly to a qualified psychologist or psychotherapist. Providers delivering second‑level services must meet specific national standards, including accredited training and recent certification in recognised therapeutic modalities. These services are funded by the state at a standard hourly reimbursement rate for individual therapy, ensuring that care is both professional and financially accessible.

Third level: Comprehensive medical and psychological care

The third tier supports veterans with more severe or complex conditions, such as PTSD and other trauma‑related disorders. Assistance is provided by multidisciplinary teams comprising at least four mental health professionals, including a psychiatrist and multiple psychologists or psychotherapists. These teams operate under medical licences and provide integrated care either in‑person or remote modalities. The state reimburses providers through a monthly global budget linked to caseload size, allowing for stable financing of intensive, long-term interventions.

Across all tiers, services can be delivered individually, in groups, or as family therapy – reflecting the government’s intention to provide holistic support that recognises the impact of war‑related trauma on households as well as individuals.

5.1.3. Strengthening provider capacity and quality assurance

To improve the quality and consistency of psychological services, Ukraine has established strict qualification criteria for mental health professionals serving veterans. Providers must hold relevant higher education, demonstrate recent professional experience, maintain active certification, and complete specialised training in internationally recognised therapeutic methods such as Cognitive Behavioural Therapy (CBT). Regular supervision is mandatory, ensuring adherence to national standards and continuous professional development.

This professionalisation effort is supported by the introduction of the Official Register of Psychological Assistance Providers, a verified digital directory maintained by the Ministry of Veterans Affairs. In early 2026, the Register lists 96 authorised organisations, each vetted for compliance with training, licensing, and therapeutic practice standards. The Registry increases transparency, facilitates user access, and lays the foundation for a more accountable system of care (Ministry of Veterans Affairs of Ukraine, 2026[43]).

5.1.4. Digital innovation for mental health support

Ukraine has invested in digital tools to expand service reach and reduce barriers to access – particularly important given large regional disparities in available mental health professionals.

MARTA: Mental adaptation and rehabilitation tools and analysis

The MARTA platform allows veterans and family members to anonymously assess their mental health, receive tailored recommendations, and access psychoeducational content (Government of Ukraine, 2023[44]). It acts as both an early-screening mechanism and a gateway to certified professionals listed in the Official Register. MARTA also supports trained first‑line personnel – including social workers, veteran organisation staff, clerics, and educators – who use the system to guide veterans through the initial stages of assistance. MARTA is operational in half of the regions, linking digital tools to local networks of psychological service providers.

Integration with national digital platforms

Veterans may apply for second‑ and third‑tier services through the Unified State Register of War Veterans, the Unified State Web Portal of Electronic Services, or the Diia app. Modernising access in this way reduces administrative burden and ensures timely linkage between veterans and service providers.

5.2. International approaches to supporting veterans’ mental health

OECD and partner countries have developed a wide range of institutional models to support the mental health of veterans during and after the transition out of military service. Although systems differ in design and resources, several common principles emerge – early identification of mental health needs, continuity of care throughout the transition period, specialised trauma‑informed services, and the integration of clinical and non‑clinical supports. Insights from Australia, Canada, France, the United Kingdom and the United States offer some general lessons for Ukraine as it builds its own national model.

5.2.1. Transition‑focussed mental health screening

International experience underscores the importance of early detection of mental health problems during the transition period. Australia, Canada and the United Kingdom have embedded mental health screening or referral mechanisms directly into their transition processes (i.e. the transition to civilian life), enabling early identification of PTSD, operational stress injuries, and other psychological conditions. By integrating screening into mandatory out‑processing steps, these countries ensure that at‑risk service members are flagged before reintegration challenges escalate.

The United States provides extensive clinical mental health services through the Department of Defense (DoD) and the Department of Veterans Affairs (VA). However, it does not universally require psychological screening during the Transition Assistance Program, making early detection dependent on individual initiative. France, meanwhile, relies heavily on the civilian healthcare system post‑discharge and has less formalised psychological screening at the transition point.

Despite differences, the experiences of these countries reveal that structured, proactive screening at or before discharge improves continuity of care and reduces the likelihood of untreated trauma during the critical transition period.

5.2.2. Continuity of support across the service – veteran boundary

A key lesson from high‑capacity veteran systems is the value of tiered and continuous support that stretches across military service and civilian reintegration.

Australia and Canada stand out for offering proactive, layered mental health support that begins during service and continues seamlessly after discharge. In Australia, the Defence and Veteran Mental Health and Well-being Strategy 2025-2030 and Open Arms – Veterans and Families Counselling (Open Arms) provide a spectrum of clinical and non‑clinical services – including 24/7 crisis lines, counselling, peer support and digital mental health initiatives – to serving members, veterans, and their families (Australian Government, Defence, 2025[45]). Canada similarly offers integrated services through the CAF Health Services pre‑discharge and Veterans Affairs Canada (VAC) post‑discharge, with medically released members automatically enrolled in mental health benefits (Government of Canada, 2026[46]).

In the United States, access to mental health care begins during active duty through DoD programmes and continues through the VA, which offers a wide range of clinical services including telehealth, residential care, and specialised suicide‑prevention initiatives. However, access often requires the veteran to actively enrol in the VA system, which can create gaps in continuity.

The United Kingdom provides services through the national health system (NHS), supplemented by defence‑linked veteran programmes such as “Op COURAGE” and “Op RESTORE”, but entry often requires self‑identification – meaning the individual must disclose veteran status to access veteran‑specific care (e.g. (Finnegan et al., 2025[47])). France again relies primarily on civilian health structures, with supplementary support from the Ministry of Armed Forces and ONACVG, but without a unified veteran‑specific mental health framework (Ministère des Armées et des Anciens Combattants, 2024[48]).

Across systems, the most effective approaches guarantee early, continuous, and automatic support – thereby minimising the risk that veterans fall out of care as they move between institutions.

5.2.3. Comprehensive clinical and non‑clinical support

All five countries maintain a broad set of clinical and non‑clinical mental health supports for veterans, differing in scale and intensity.

Clinical support includes evidence‑based therapies, trauma‑informed care, and specialised treatment for PTSD and operational stress injuries. The United States and Australia have developed national peak bodies addressing the impacts of trauma and offering information and training for lay people and for clinicians, anchored by institutions such as the U.S. National Center for PTSD (U.S. Department of Veterans Affairs, 2026[49]) and Phoenix Australia (Phoenix Australia, 2026[50]). These systems help ensure consistent quality and build deep expertise in military‑related trauma.

Non‑clinical supports – e.g. peer counselling, helplines, family support, and community‑based initiatives – are widely used and often serve as critical first points of contact. Australia’s Open Arms (Australian Government, Department of Veterans' Affairs, 2026[51]) and Canada’s Operational Stress Injury Social Support (OSISS) programme (CFMWS, 2026[52]) represent particularly mature models that integrate peer support with early identification of distress, referrals, and ongoing psychosocial assistance.

5.3. Avoiding mistakes and charting a sustainable path forward

Despite strong understanding and ambition and apparent progress, mental health support remains one of the weakest components of Ukraine’s veteran assistance system. Surveys indicate that only 15.4% of veterans feel their psychological needs are fully or mostly met (Ukrainian Veterans Foundation, 2024[53]) while almost 50% of all veterans and family members consider mental health support as the number one need for which they plan to seek help (The Veteran Mental Health Center of Excellence, 2025[54]). Left unaddressed, mental health issues will deepen social exclusion, reduce labour market participation and economic growth, and place a growing burden on families and communities. To respond to the challenge, Ukraine should focus on five strategic priorities:

• Make mental health a core pillar of demobilisation and reintegration

• Close the awareness and trust gap

• Scale up the mental health workforce rapidly and strategically

• Build long-term, continuous care pathways

• Develop targeted programmes for high‑risk and underserved groups